Blog of the Society for Menstrual Cycle Research

Last week, Loretta Ross, the pioneering women’s health activist, came to Boston for a public lecture. Ross will keynote at our upcoming “Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan” (What? You didn’t hear?). Hearing her speak tripled my excitement for her keynote in June. I, a serious fangirl, listened intently as she narrated a personal history of the women’s health movement and offered a clear-eyed, no nonsense way forward. This lady knows some stuff! If you don’t know Ross, you should. For one, she was one of 12 women who developed the globetrotting concept of “Reproductive Justice”—which intersects social justice and reproductive rights, or as Ross, puts it, “brings Human Rights home by looking at the totality of women’s lives.”

Though I generally resist militarized language, I also know that the persistent assault on abortion rights is nothing short of a war against women. Many of us, caught up in our own fisticuffs on neighboring battlegrounds (for affordable better birth control, against pinkwashing, for comprehensive sexuality education, for transgender health care), may not realize how our struggles are, indeed, united. We are all fighting for bodily autonomy, after all. Ross’ remarks made clear to me how our battles are united and that we will NOT win any of them if we don’t manage to see these connections.

Let’s look at how the abortion issue and menstrual health are linked.

To begin, thinking about abortion in a REPRODUCTIVE JUSTICE framework allows us to address what Ross calls the “Oh My God!” Reactions many women face when they think they might be pregnant:

1) OMG! I am in an abusive relationship. What do I tell my partner? Will I be safe?

2) OMG! I am 16. What will my family say?

3) OMG! I am a college student. Can I finish school?

4) OMG! I have no health insurance? How do I pay for this?

When we pay attention to the OMG reactions, we acknowledge the reality of women’s lives—and the complicated context that shapes reproductive decision making. And as we consider that context, we have to tune into the following:

• Safe abortion is not enough. It must ALSO be safe to TALK about abortion.

• We need ‘kitchen table conversations’ about women taking reproductive knowledge back into our own hands. (And my favorite line of the night: “Why are we ceding the responsibility of our bodies to a bunch of assholes. We built a women’s health movement. Let’s act like it.”)

• We absolutely must listen to Women of Color and the issues that matter to them (e.g voting rights, immigrant rights).

The menstrual connections are evident here. Do you see them, too? Improving menstrual health through menstrual literacy for health care workers and menstruators alike is fundamental to winning this war.

I submit the following:

FIRST: Breaking Silence. Yup. Challenging menstrual shame, silence and secrecy is JOB ONE for many of us. We know that our cultural allergy to making mensruation audible and visible (to quote filmmaker Giovanna Chesler) is at the root of menstrual ILLiteracy which leads to poor reproductive health. Imagine if menstruators felt supported to speak up when they had questions about their cycles—from pre menarche (what does a period feel like?) through menopause (is this heavy bleeding normal?).

SECOND: Taking our health care into our own hands. Do It Yourself. DIY has been foundational to the women’s health movement since its genesis. DIY vaginal exams. DIY menstrual extraction. Menstrual activists, at least since the 70s, have been promoting DIY menstrual care as a way to take control BACK from the body shaming FemCare industry while doing our part to protect the planet.

THIRD: Paying attention to Women of Color in everything we do. When it comes to ANY reproductive health issue, race matters. White supremacy, capitalism, and patriarchy have had disastrous effects on women of color’s lives (sterilization abuse, higher mortality and morbidity for heart disease lung and breast cancers, and HIV/AIDS are just a few examples).

Using a critical race lens on menstrual and ovulatory health sharpens our focus and begs important questions, such as: Continue reading...

The recently released rom-com ‘Obvious Child’ has been discussed far and wide for its mature, sensitive and funny approach to the topic of abortion and yet I have not seen one comment on the fact that this movie also makes mainstream (and yes, funny) the topic of cervical mucus.

In the opening scene stand-up comedian Donna (played by real-life comedian Jenny Slate) is performing on stage at her local open mic night. She wraps up with a joke about the state of her underwear and how, she describes, her underpants sometimes look like they have “crawled out of a tub of cream cheese.”

She claims that they often embarrass her by looking as such during sexual encounters, something she feels is not sexy.

Of course, by “cream cheese” I immediately assumed Donna meant cervical mucus. Unless she is supposed to have a vaginal infection – which seeing as it is not discussed amongst the other myriad bodily function-centric conversations in the movie, I doubt to be the case – then it’s clear she is detailing her experience of cervical mucus.

Later on that night, when Donna meets and goes home with a guy, has sex and then wakes up in bed with him the following morning, she sees that her underwear is laying next to the guy’s head on the pillow. Not only that, but this is one of those situations she finds embarrassing as the underwear is actually covered in the aforementioned “cream cheese” or cervical mucus. She cringes, retrieves the underwear and hastily puts it back on under the covers.

At this scene we can assume that the presence of visible cervical mucus indicates that the character is in fact fertile at this time during the movie. Even if we didn’t know this movie was about unplanned pregnancy, perhaps we would know now. Apparently Donna is not on hormonal birth control, and she’s not sure if, in their drunkenness, they used a condom properly. So, I speculate, if Donna had known she was fertile and that the “cream cheese” in her underwear was actually one of the handy signs of fertility her body provides, then she may have taken Plan B and not had to worry about an abortion. But, then, of course, we wouldn’t have had the rest of this movie. We would have had a very different movie – a movie someone should also make.

But it goes to show how some body literacy might go a long way in helping women make more informed choices. The abortion sets her back $500 and causes some emotional turmoil. A dose of Plan B is cheaper and easier to obtain, although not without some side effects. Maybe even, we can speculate, if Donna had known she was fertile she might have avoided PIV sex that night.

It’s great to see a movie approach the choice of abortion as though it really were, well, a choice. But isn’t it interesting that in doing so it shows how women can be hampered in their choices by a lack of body literacy?

We often see women in movies discussing their “fertile time” in regards to wanting to get pregnant – and so meeting their husbands to have sex at the optimum time in usually funny, crazy scenarios. Sometimes we have seen women taking their temperature or using ovulation tests and calendars to figure this out. However, I think this might be the first mention of cervical mucus in cinema.

I had the honor of seeing this movie with longtime abortion rights and women’s health activist Carol Downer and getting to discuss it with her after. Carol pioneered the self-help movement and self-examination, adding much to our collective knowledge of our bodies.

A few years ago, in response to an article of mine on menopause, an editor encouraged me to think of women’s reproductive lives as “recursive”. Little did he know how much his comment would affect my thinking about women’s lives and life in general. Recursiveness is a common sense concept, but something we don’t often think about. But, especially in light of the “new” year and the sense that we all hold that we are beginning 2014 as if we have a clean slate, I decided to blog here about recursiveness. This is very relevant for anyone thinking about menstruation and menopause, which is why I write about it here.

If you look up the word “recursive” in a dictionary, you find this as one of several definitions:
“of, relating to, or constituting a procedure that can repeat itself indefinitely…”
— re•cur•sive•ly adverb
— re•cur•sive•ness noun

If you think about reproductive events like menstruation, menopause, pregnancy, childbirth or anything else, we often think of them one at a time, almost in isolation. But, they’re not isolated at all and many of them have a tendency to repeat because of the cyclical nature of all life processes. In addition, reproductive events are tied to each other in meaning and we think of them only in relation to what comes before and they only mean things in relation to what other events meant to us in the past or what situations we are dealing with in the present. Thus, potentially when two menstrual periods or other reproductive events occur, we might tend to think of them similarly, approach them similarly, and/or compare them even when they could be very different, because the first experience colors the second and beyond. To think that we might approach each reproductive event as it comes as something new and unrelated to past events or experiences is almost silly, for the past always colors our perceptions of things even if it shouldn’t. Likewise, if we think of 2014 as a brand “new” chunk of time that represents a blank slate, we are also fooling ourselves (perhaps we do so knowingly though). We can make different decisions or act somewhat differently if we’d like, but we approach 2014 with our past in mind and potentially may repeat our attitudes and behaviors in the future automatically. Even if we live different experiences in the new year and very purposely separate ourselves from past attitudes and behaviors, we might think of our new attitudes and experiences in relation to other past experiences, making attitudes and behaviors recursive in meaning at least (even if our newer experiences are not the same as in the past).

I have written here about similar themes in the past, and I do really like thinking about the recursiveness of our experiences. My brother is a forester and farmer and always talks about nature’s cycles and tendency towards repetition, but I think we can think about recursiveness in much broader terms than that too. Recursiveness is a powerful idea and it makes a lot make sense in the world. It doesn’t mean we can’t experience things differently over time. Thinking about transitions like menopause makes us realize that things (like menstruation or fertility) are definitely not the same over time and maybe stop repeating and cycling. But, in our minds, we might expect things to repeat indefinitely (and therefore emotionally wrestle with the physiological changes we experience because we don’t expect change). Previous experiences might repeat in the identities we continue to hold dear or in the ways in which we think about reproductive transitions or any other changes in our lives, even when the experiences themselves change.
As we approach this new year, I propose we acknowledge recursiveness as a real thing.

Guest Post by Amy Sedgwick, HRHP, Red Tent Sisters

Screenshot of Selene app // Photo courtesy of daringplan.com/selene

While there are no shortage of apps designed to help women track their periods, finding an app that meets the needs of women who are practicing fertility awareness methods (FAM) for birth control or conception can be quite a challenge. As a teacher of the Justisse Method of Fertility Management (there is currently no app available but there is one in development) I am often asked by my clients about web-based solutions to tracking their cycles when they are travelling or find themselves in other situations where their physical charts are impractical. Fertility Awareness users will be pleased to know that there is a new app on the market, Selene, which has been developed with FAM in mind. In addition to being able to chart the standard fertility markers (cervical mucus, cervical position, and basal body temperature), Selene boasts loads of unique features like the ability to make note of the things that affect reliability the most – like sickness, travel, and disturbed sleep. Selene also allows the user to define their own markers to track patterns in health, mood, libido, and more. The chart tab of the app shows you your cycle in a graph format, while the calendar tab displays it from a monthly perspective. Some of the other highlights of the app include a description of the daily moon phase, an automatic luteal phase calculator, the ability to ask questions about your chart in the “Ask an Expert” section, and a detailed instructions and help section. Selene excels at utilizing the principles of the widely-used fertility awareness method taught in Taking Charge of Your Fertility. Using principles from the book, the app will shade out days of predicted fertility based on the information you enter. It will also calculate an ovulation prediction based on the average length of your cycles. The app highly encourages users to seek additional support and education for their fertility awareness practice, particularly if they are using it for birth control. While Selene offers the most nuanced approach to menstrual cycle charting that I have thus seen (although I can’t claim to have evaluated all the apps on the market), one feature I would like to see added in future versions is the ability to manually choose whether a day is considered fertile (i.e., as indicated by bold stripes on the calendar view) so that those schooled in other approaches to fertility awareness, like the Justisse Method, could have the option of applying our own rules and calculations overtop of the calendar view. The only other critique I have of Selene is that the developer has chosen a dark navy background, which I personally find difficult to view. I’d prefer to see them use a colour scheme that is brighter and easier to read. I am grateful to Selene’s creators for being so thoughtful, thorough and conscientious in the creation of their app. I look forward to seeing what enhancements and updates they integrate into future versions.

Two new suppositions about menopause have been tossed around the media in recent weeks. They make for racy headlines but both, unfortunately, perpetuate the myth that menopause is a disease women need to be protected from.

Most recent was the assertion by researchers from McMaster University in Hamilton, Ontario, Canada, that menopause in women is the unintended consequence of men’s preference for younger mates.

Men to blame for menopause

The writer with her mother Erna Sawyer who turns 95 on July 20, 2013. Is menopause an “age-related disease” that science must figure out how to prevent or an evolutionary adaptation for longevity?

Evolutionary biologist Rama Singh, co-author of the study published in the journal PLOS Computational Biology, gave this explanation in a CBC news story: “What we’re saying is that menopause will occur if there is preferential mating with younger women and older women are not reproducing.”

The study used computer modelling to arrive at this hypothesis. Singh said that this “very simple theory”…”demystifies menopause…It becomes a simple age-related disease, if you can call it that.”

Well, no Mr. Singh, you can can’t call menopause a disease. I challenged this idea in response to the Canadian Heart and Stroke Foundation’s Death Loves Menopause ads in February 2012.

Yet there he is, hoping his work will prompt research on how to prevent menopause in women, helping us to maintain better health as we age. What does he really know about menopause anyway?

Another stupid idea about menopause surfaced in late May with headlines like: Women could evolve out of menopause ‘because it is no benefit to them.’

Women could evolve out of menopause

The story, covered by media everywhere, was based on comments by biologist and science writer Aarthi Prasad at the 2013 Telegraph Hay Festival, Britain’s leading festival of ideas.

The Daily Mail reported that if women evolve out of menopause we could then have children well into our 50s (But how many women want to?), and that “targeted gene therapies will be developed to treat the condition.”

We’ve been fighting the assumption that menopause is a “condition” that needs to be treated for decades, with members of the Society for Menstrual Cycle Research at the forefront of this assumption-busting.

Quoted in The Telegraph, Prasad also said, “What we think is normal is not normal for nature. If it is something not in all mammals, is it something necessary or beneficial for us? I do not see any benefits.”

Wow! Menopause is not “normal for nature.” But what about the argument made by doctors like Elsimar Coutinho who promote menstrual cycle suppression, who assert incessant ovulation (i.e. reproductive capacity) is not natural, normal or healthy in humans, therefore we should take drugs to stop it?

These doctors and scientists need to get on the same page. Which is it? Do we ovulate too much or do we not ovulate enough?

As for “no benefits” to menopause consider this: What if menopause is an evolutionary adaptation that works in women’s favor?

Do women live longer, healthier lives because of menopause?

An October 2010 story in The Calgary Herald - Why don’t monkeys go through menopause? - discussed the research of University of Calgary anthropologists Mary Pavelka and Linda Fedigan who’ve spent years documenting the aging and reproductive histories of Japanese female macaques.

Few study subjects lived past their reproductive capacity, about age 25, and those that did showed signs of serious physical deterioration. For these primates, retaining the ability to reproduce until late in life did not make them healthier. Fedigan noted that they were “crippled up with arthritis, their face is all wrinkled and their fur is falling out.”

The question, they noted, was why would human females lose their ability to reproduce in healthy middle age?

“One hypothesis is that it’s a byproduct of evolution for longevity in humans,” Pavelka said.

Now here’s an idea that makes sense. Think about it. Men produce sperm – albeit of dwindling quantity and quality – until they die; women transition to menopause and can live healthy lives for decades after. Women live significantly longer than men. Therefore, it’s reasonable to hypothesize that menopause supports longevity in women. Continue reading...

OB-GYNS receive little to no medical training about menopause. Or at least that’s what recent research results show. Results of a web-based survey of 258 OB-GYN residency training directors across the country suggest that about one in five doctors receive any training on menopause, but that as many as seven in ten would like to receive that training. Residency training directors were asked to forward the survey to their residents, leading to a sample of 510 residents responding to the survey. Of the residents who responded, only 20% (100) reported any formal curriculum on menopause and only 78 residents reported participating in a hands-on “menopause clinic” as part of their residency. News articles reporting on this study suggest that this is a major problem considering how many women (as many as 50 million by the year 2020) are entering menopause in recent years.

My reaction to this is simple: of course there is little to no medical training on menopause. Of course. Anyone who has ever been to the doctor (for a simple cold, for a reproductive reason, or anything else) knows that doctors are easily stumped and that their training is often surface-level. If you present anything besides a “normal” case, the likelihood is that doctors will not have in-depth knowledge of your condition (regardless of whether that condition means you’re “healthy” or “sick”). In addition, if your body or your reproductive system represents something besides the norm then you should just brace yourself for doctors’ lack of knowledge about your body. Individual doctors are not necessarily at fault for this since they do not get training on aging bodies, disabled bodies, reproductive bodies that do not behave according to textbook info — let alone the fact that the male body is really the norm and so women are already at a disadvantage since their reproductive bodies already represent an abnormal case. I’ve interviewed menopausal women who’ve talked about going to the doctor and having those doctors not really know much about their symptoms. I’ve also interviewed women who have had hysterectomies but then are not told anything about what effect that hysterectomy might have on long-term health or menopause. I have a student who just completed a dissertation on the reproductive experiences of women with sickle cell disease, and it is clear from her study that doctors have no idea how to deal with the reproductive needs of women with a congenital disease. I’m also working on a project about women with spinal cord injuries who can’t even find a doctor who will give them a proper pelvic exam because doctors have no idea how to handle a body that does not neatly fit on an exam table.

Women who really want answers learn to strategize about how to cobble together knowledge about their health or illness by seeing multiple doctors, going to alternative doctors as well as mainstream doctors, consulting others who have the same health or illness, doing their own research outside of medical institutions, and to some extent just putting up with their bodies and life stages without medical help. Women learn these strategies over time as doctors remain unable to help them. This is not a new situation by any means, rather it is just what women have learned (or have to learn) to expect over time. As much as biomedicine would like to declare doctors as the experts on women’s health and health or illness in general, in practice we know that doctors are not these experts. They are probably trying the best they can most of the time, but just have little training and knowledge in anything specific. Unless an individual doctor becomes extremely proactive and wants to seek out extra knowledge by themselves, the likelihood is that they will only have cursory knowledge of specific women’s health conditions or life stages. This means that women have to be ready to be their own experts and know their own “normal” in any life stage, because we cannot rely on doctors to have any training that might help us. Yes, on one level, this is a serious problem but, on another level, this is just reality.

Guest Post by Kati Bicknell, Kindara

It has been brought to my attention several times that not all women’s cervical fluid matches the usual descriptions of sticky, creamy, egg white, or watery. This means some women are having a hard time charting their fertility, because they don’t know how to categorize their cervical fluid for their chart.

So today I’ll give you very detailed descriptions of the different types of cervical fluid, and how to classify them.

I’m going to be incorporating vaginal sensation into the mix here. Vaginal sensation is the way your vagina *feels* when different types of cervical fluid are present. You know how you can tell if the inside of your nose is wet, like when you have a runny nose? And you know how you can tell if the inside of your nose feels dry, like when you are in a dusty desert? You can tell the same things about your vagina as well, if you pay attention. The way your vagina feels can give you a lot of insight on the state of your fertility and what kind of cervical fluid you’re likely to find.

One thing to keep in mind when it comes to cervical fluid is that there is a baseline level of moisture that will always be present in the vagina. After all, it’s a mucus membrane, like your mouth. If you touched the inside of your cheek, it would be damp — same thing with the vagina. Don’t let that normal vaginal moisture confuse you. Unless there is a physical substance on your fingers or toilet paper, it doesn’t count as cervical fluid. (The exception here is watery cervical fluid: sometimes the water content is so high that there is nothing that will hold together, and it’s just plain wet. But in those cases there is usually so much of it that there is no question about whether or not it’s cervical fluid.)

Cervical fluid is measured above that baseline level of moisture. It tends to start out on the drier end of the spectrum, and it increases in water content as a woman approaches ovulation. Generally, the higher the water content, the more fertile the cervical fluid. After ovulation the water content will decrease.

Note: all cervical fluid is potentially fertile. If you are charting to avoid pregnancy, any cervical fluid you notice before ovulation means that your fertile window has begun. But for women who are trying to achieve pregnancy, there are definitely types of cervical fluid that are more optimal for getting pregnant. So, shall we launch our boat onto the sea of cervical fluid exploration? Lets!

These are the different categories of cervical fluid.

None:

What it feels like (vaginal sensation): dry, or like “nothing’s going on.”

What it looks like: nothing! Maybe a slight dampness on your fingers that will quickly evaporate.

What it feels like on your fingers: a slight dampness.

What it looks like on your underpants: nothing. Squeaky clean. You could wear those underpants again tomorrow if you wanted to (ain’t no one gots to know about it!).

Sticky:

What it feels like (vaginal sensation): dry, sticky, or like “nothing’s going on.”

What it feels like on your fingers: springy, sticky, crumbly, dry, pasty.

What it looks like on your underpants: white or yellowish lines or areas that tend to sit on the top of the fabric, as opposed to soaking in. When it dries it forms a crust that can hard to wash out on laundry day.

Creamy (similar to sticky, but with a higher water content.):

What it feels like (vaginal sensation): cool, slightly damp, or may not feel like anything.

What it looks like on your underpants: white or yellowish lines or areas that tend to sit on the top of the fabric, as opposed to soaking in. When it dries it forms a crust that can be hard to wash out on laundry day.

What it feels like on your fingers: slippery or lubricative or stretches an inch or more between thumb and forefinger.

What it looks like on your underpants: slippery, wet, may sit on top of the fabric, or soak in slightly.

Watery:

What it feels like (vaginal sensation): water rushing, dripping or gushing out of your vagina; cold, wet sensation.

What it looks like: clear or milky/clear, about the consistency of water or skim milk.

What it feels like on your fingers: wet, slippery.

What it looks like on your underpants: leaves round wet patches that soak into your underpants.

I’m sure I left out some possible descriptions of cervical fluid here. If I didn’t name one that you’ve personally experienced, let me know in the comments. I’ll add in more descriptors as needed, so we can make the most thorough cervical fluid compendium known to humankind!

We posted “Sassy Girlz Candy Birth Control Pills” (written by Carissa Leone in 2011) in our regular installment Weekend Links on Feb 2. I had a mixed reaction. And when a couple re:Cycling readers described the video as “nasty,” I knew we needed to dig in a bit.

Let’s discuss.

There’s something very absurdly funny about eating birth control, even if the women are still tweens and the birth control is merely mulit- colored jelly beans intended to get young girls in the pill-popping groove before they are saddled with a baby and an half-finished high school education.

First of all, women CAN eat their birth control, donchaknow… Warner Chilcott brought to market their chewable, spearmint flavor oral contraceptive, Femcon Fe, for women who have difficulty swallowing pills and apparently, find stopping for 30 seconds to swallow water.

But I digress (I guess I just want to be clear that we are ALREADY munching our pills).

It is hard not to love how this sketch takes down the pandering to the girl tween market. Oh lordy. There’s so much potential there! (one estimate figures that kids aged 8-12 years are spending $30 billion OF THEIR OWN MONEY and nagging their parents to spend another $150 billion annually!) Little girls quickly move from Disney to diets, from fingerpaint to fake eyelashes, from tutus to belly shirts…..I have seen it with my own girls and it feels, frankly, like an inexorable force.

Viral sketch writer Carissa Leone graciously replied to my questions regarding the piece. When I asked her what inspired her, she channeled her Women’s Studies training (go team!) and supplied her two main reasons:

(1) “I saw a little girl on the subway,holding a baby doll in one of those pretend baby slings…and I thought, “If only she really knew what motherhood was like. I wonder if anyone has explained the authentic experience. I wish she were carrying a briefcase and reading a teeny issue of Ms. magazine instead… “

AND

(2) “The idea that women can/should have it all, in terms of relationships and families and career still seems to be put forth as a tangible (and”correct”) goal in Western culture. It’s a pressure I and many other peers feel, and one that I don’t think is truly possible, or necessarily awesome.”

And Big Pharma takes a hit, too, per the spot’s director, Brian Goetz, who offered this when I asked him about what led to the sketch:

“I wanted to do the video because the script spoke so well to the branding of pharmaceutical commercials, where no matter what the product, as long as you say there’s a problem and that you have the solution, throw some happy people and fun b-roll in it, you’ve got a successful campaign. On top of that, it’s always fun to legitimize terrible ideas in sketch comedy. And if that means having multi-colored jelly bean birth control pills, all the better.”

But I think there’s more to it that that.

Why do I find myself laughing and crying at the same time? Well, I just finished my advance copy of Holly Grigg-Spall’s forthcoming Sweetening the Pill or How We Became Hooked on Hormonal Birth Control(out this Spring with Zero Books). In it (and here as well, on this blog), Grigg-Spall makes the case the hormonal contraceptives have become so normative that we, as consumers, permit an imperfect (at best) product to flourish even while other options may be more appropriate. The one-pill-fits-all mindset is so pervasive and bores in so deep, so young, Grigg-Spall argues, that when someone says, ‘hey! I don’t want to be on the pill,’ these—what she calls “pill refugees” — are hastily branded as irresponsible, antifeminist, or just plain dumb. That is, the pill gets constructed as our savior, our liberator, our saving grace, even when its not.

And that’s where this spoof enters….since the pill IS all these things, let’s get those girlies on board NOW! Why wait? Good habits start young, after all. And product loyalty is not just for toothpaste and laundry detergent….

And so, “Sassy Girlz Candy Birth Control Pills” is super smart feminist critique. It calls out the enduring wrongheadnessness of romanticizing motherhood and co-opting what I would call a tragically hollowed-out pseudo feminism harnessed to push product:

Little girls playing Mommy is cute, and kinda bullshit!

Its never too early to teach little girls about options!

She’ll know that birth control means winning a college scholarship

Yup. There’s lots of problems with that. Thanks to the feminist satirists to help us see.

But I have to say one more thing.

Leone and I discussed (what I consider) the unfortunate below-the-belt invocation of gender dysphoria to as she put it, “most absurd, heightening beat” in the sketch (here’s another, more recent example of same, on SNL). I don’t think trans or gender queer or otherwise gender variant people should ever serve as punchlines, as I told Leone so in our email exchange. When I inquired about this moment in an otherwise spot-on sketch, she said that is was never intended it as a negative perception of transgendered kids. But still it is, and I think it points with a big fat finger at how much work we still need to do to move trans issues from margin to center.

It is dense and complex, but what I’ve been looking for is any acknowledgement that hormonal contraceptives are endocrine disrupting chemicals (EDCs).

Hormonal contraceptives clearly act as EDCs according to the definition used in this report:

An endocrine disruptor is an exogenous substance or mixture that alters function(s) of the endocrine system and consequently causes adverse health effects in an intact organism, or its progeny, or (sub) populations. A potential endocrine disruptor is an exogenous substance or mixture that possesses properties that might be expressed to lead to endocrine disruption in an intact organism, or its progeny, or (sub) populations.

Adverse health effects would include, in this context, anything that disrupts the reproductive systems of humans (and wildlife) or contributes to other health problems such as hormone-related cancers, thyroid-related disorders, cardiovascular disease, bone disorders, metabolic disorders and immune function impairment. Hormonal contraceptives certainly disrupt the reproductive system and have been associated with increased risk of cardiovascular events, loss of bone density, decreased immune function and, in some studies, increased risk for breast cancer. Metabolic disorders? Recent research suggests that long-acting progestin-based birth control may increase risk in obese women for Type 2 diabetes.

The only mention I could find of specific contraceptive chemicals is in section 3.1: The EDCs of concern. In a table under the sub-heading Pesticides, pharmaceuticals and personal care product ingredients, two key components of hormonal contraceptives are listed: Ethinyl estradiol, the synthetic estrogen used in most oral contraceptive formulations, and Levonorgestrel, a synthetic progesterone used in combined oral contraceptive pills, emergency contraception, the Mirena IUD, and progestin-only birth control pills. Levonorgestrel is considered of “specific interest.”

The concern with these chemicals is not the effects they may have on women taking them, but on the possible reproductive impact on wildlife from the excretion of these chemicals into the aquatic environment. It seems ethinyl estradiol and levonorgestrel are considered safe contraceptive drugs when taken by choice to disrupt fertility, but EDCs worthy of concern when such disruption is unintended.

How would it change our perception of hormonal contraceptives if we acknowledged them as endocrine disrupting chemicals? Would we wonder why there is no discussion of how these EDCs might contribute to the health issues considered in the report? Would we ask why hormonal contraceptive EDCs are routinely used to “treat” (meaning only to alleviate symptoms of) endometriosis, fibroids and PCOS – conditions potentially caused by other EDCs?

Another relevant concern addressed in the report is the effect of “estrogenic agents, and their role in breast cancer.” The report states there “is good experimental evidence that estrogenic chemicals with diverse features can act together to produce substantial combination effects.” I have to wonder how hormonal contraceptive EDCs fit into this mix.

Here’s something to ponder. Last week news stories reported that the incidence of advanced breast cancer among young American women, ages 25 to 39, has risen steadily since 1976. Lead researcher Rebecca Johnson was quoted as saying, “We think it is a real trend and, in fact, it seems to be accelerating.” The increase is small in relative numbers, only 850 cases in 2009, but the “trend shows no evidence for abatement.”

Researchers can’t explain the increase. Lifestyle changes, obesity, sedentary lifestyle and toxic exposure to environmental chemicals are offered as possible factors. But what about the hormonal contraceptives many women of this generation have been taking since they were 15 or 16 years old? Surely these EDCs must be considered as potentially contributing factors.

A couple weeks ago, I received the following ‘thanks, but no’ to a proposal I sent to a reproductive justice conference,

Dear Chris Bobel,

Thank you for submitting your proposal, “How Menstruation Matters to the Reproductive Justice Movement”…..Our staff has spent the last few months evaluating proposals and building an initial workshop list. We were inspired by the volume of quality proposals that we received. All of them helped us in the planning process.

At this time, however, we are not accepting your proposal for the 2013 conference.

Ouch.

As I typically do, I immediately headed to the deep dark brooding place of self-recrimination. That’s where I go. But as I set afoot on this well-worn path to my special ugly place, I did something I don’t usually do; I paused, lifted my head and looked around.

As I did, I wondered, if just maybe, the rejection was not the result of the deficits in my proposal, but rather, a reflection of the broken link between menstrual awareness and the broader movement for embodied autonomy.

In other words, maybe the rejection was not as much about me (and my failings) but more about the world around me, and ITS (meaning OUR) failings as a culture to see how a certain bodily reality is part of a larger whole. Maybe the fact that a team of progressive reproductive justice activists and scholars saying NO THANKS to an opportunity to make the essential linkages between the menstrual cycle across the lifespan and reproductive justice is an indication that WE still have SO MUCH WORK TO DO to help people see this crucial connection.

I know I am not alone in feeling like the spotted elephant on the Island of Misfit Toys (seasonal reference: DONE!). Sister menstrual warrior Laura Wershler recently wrote the following when I this blog post-in-progress:

Caring about menstruation and the menstrual cycle makes me almost a freak in the pro-choice world. I get ignored or criticized a lot because people don’t want to ask or answer some of the questions I keep trying to pose about choice around non-hormonal contraceptive methods.

So what’s a freak to do? We could stamp our feet and curse those who don’t see what’s pretty obvious to us, but that won’t raise the awareness.

This is on us.

Yes. Rejection stings, but maybe this time, I can take something away far more productive than the usual self-flagellation. Maybe this time, I can take it in as a clarion call, a motivation for a deeper commitment to help others make the menstrual connection, to, spread the #menstruationmatters message (thanks again Laura Wershler).

This means more conference proposals (and a thicker skin for more rejections). More writing. More blogging. More teaching. More radio interviews. More everything.

Your fertility is not a deep, dark mystery only your doctor can unravel. It’s yours to own, understand and manage. Forget the ticking biological clock, it’s the wrong metaphor. Fertility ebbs and flows, like the phases of the moon. It’s about the cycle – not the clock.

Are you wondering about your fertility status? Will you be able to have a baby when you want to?

Seems these questions are on the rise for 20- and 30-something women who are finally getting the message that putting off motherhood may not be a good idea. Recent news stories report that young adults don’t know the facts of fertility decline and overestimate the success of reproductive technologies.

A third woman, turning 30, with a committed partner and a great job, made fertility sound like the new “f” word as she glumly remarked to a friend ,“My doctor told told me my fertility just dropped 50 per cent. Crap.”

This is crap. It misrepresents how fertility works. Timson writes that “young women – and men – are crying out for more factual, emotionally neutral information on how their fertility works.” Forgive me if I, and at least 700,000 others – the number of people who have purchased Toni Weschler’s Taking Charge of Your Fertilitysince it was first published in 1995 - shake our heads in frustration.

What women need is body literacy, the know-how to observe, chart and interpret our menstrual cycle events so that we – not the doctor, not the lab tech – can confirm our fertility status. Yes, it’s called fertility awareness, and, since the late 60s, millions of women world-wide, including me – a bonafide pro-choice feminist, have used this life skill to both avoid and achieve pregnancy.

If you’re worried about your fertility, here are five things you need to know:

You can learn to observe and chart three key signs of fertility: a) fertile cervical mucus b) basal body temperature shift c) adequate luteal phase, or number of days from ovulation to next period.

If you use hormonal contraception (HC), you have been infertile for as long as you’ve been using it. When you stop HC, your body has to establish healthy ovulatory menstrual cycles before you become fertile. Health and environmental factors may impact this process. Factor recovery time into your baby plans.

If you began using HC as a teenager for heavy bleeding, painful periods or irregular cycles chances are your reproductive system has not fully matured. When you quit HC this maturation process will resume. Depending on the method you used, it could take months before you have ovulatory, fertile cycles. Be patient. Holistic Reproductive Health Practitioners can assist in recovering fertility.

Fertility is individually, not statistically, determined. It can ebb and flow from cycle to cycle. Diet, stress, travel and trauma can result in anovulatory, or infertile, cycles. When it comes to getting pregnant, the more you know about your own menstrual cycle, the better.

Fertility awareness is empowering, but Toni Weschler says that in her decades long experience she has repeatedly seen the sense of excitement that women feel evolve into anger. “Women want to know why they weren’t taught this when they were teenagers.”